Leaving a legacy

The elderly are an underused, and under-cherished, resource, according to geriatrician Dr Craig Whitehead

Associate Professor Craig Whitehead never had plans to become a geriatrician.

In fact, he had his sights set on being a respiratory physician after he graduated from Flinders University in 1990, but it only took 2 weeks as a registrar to realise that wasn’t for him.

“I had 12 consultations in a row, all with emphysema patients, and I thought I can’t keep doing the same thing over and over again”, Professor Whitehead tells the MJA.

Fortunately, his next rotation was in geriatrics with “one of the best physicians I’ve ever worked with”, he says.

“He tried to solve his patients’ problems. I was very inspired by him.”

Professor Whitehead has been working with the elderly of South Australia ever since, and at the age of 48, is now also president of the Australian and New Zealand Society of Geriatric Medicine, as well as a teacher at Flinders University and clinical director of aged care in the Southern Adelaide Local Health Network (SALHN).

South Australia, it turns out, is a very good place to be if treating the elderly is your chosen career.

“It’s the second oldest state in Australia (behind Tasmania)”, he says.

Professor Whitehead is particularly involved with dementia and cognitive impairment, something he puts down to an early interest in psychiatry.

“Patients with dementia are a fascinating group of people to deal with”, he says.

“Yes, there is a lot of sadness to confront, and in a way they are losing their essential humanity, but I also see the great sides of human nature and am reminded daily of how good people can be.”

Much has changed in the 20 or so years Professor Whitehead has been working with the elderly.

“This is the great thing”, he says. “More and more we are improving our scientific knowledge — there is a lot of research being done on dementia and frailty.”

The other big change he has witnessed is the way in which dementia patients are managed.

“These days we try to help people plan and manage their lives with dementia”, Professor Whitehead says.

“Now, many of those with early dementia are living good and full lives and are still happy.

“It’s very hard to deal with the unknown, but if they know what’s going on, it can make life much easier to manage.

“The elderly have a great capacity to adapt.

“They can take the terrible and make it normal, find meaning in terrible conditions.”

The phrase “if you live long enough, you’ll get either cancer or dementia” is one heard often in some circles of medicine, but it’s not a view to which Professor Whitehead subscribes.

“I don’t think dementia is inevitable”, he says.

“Alzheimer disease has very specific metabolic pathways which we can interfere with.

“Probably dementia is preventable.”

Lifestyle choices are key, he believes.

“There is very good evidence that if you are a lifelong exerciser then your risk of developing dementia is lower.

“Even if you start to be active before late middle-age, you can lower your risk.”

With talk in the air of raising the retirement age to 70 before the federal Budget on 13 May, Professor Whitehead is frustrated by the lack of investment in Australia’s seniors.

“We shouldn’t lose sight of the contribution the elderly can and do make to society”, he says.

“There’s a very depressing view of old age in our society: that they are isolated in a state of abandonment, with no morale, not exercising, not interacting.

“We haven’t invested in them. Until we start to take advantage of their knowledge and experience, we are wasting them.

“And, if we don’t engage with them, they will deteriorate.”

It’s clear Professor Whitehead has a lot of time for the elderly.

“I do like them”, he says.

“I find dealing with them enormously satisfying. They have wisdom, and have learned how to deal with the world.

“You tell them bad news and they accept it, while their children might be devastated.”

It’s time governments stepped up, he says.

“I do get frustrated because we underestimate the elderly and as a result I’ve seen some demoralised older people who feel as if they’ve been cast away.

“We need to start planning for them. There is a lot of work and volunteering that 65–75-year-olds can do.

“The reality is that after retirement we probably have 20 good years left. We’re all going to be there one day.”

Now managing several hundred beds in the SALHN, Professor Whitehead is content with his lot in life.

“My biggest passion is trying to craft a health care system that operates within the limits of state budgets and still delivers a high-quality outcome”, he says.

“If I can do that and leave a self-perpetuating structure, that will be enough for me.”

Cate Swannell

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